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Articles, case studies, and success stories to guide and inspire healthcare HR, Organizational Development, and Clinical professionals.


Healthcare Payment Reform Driving Innovative Staffing Models Catalyst Learning
Healthcare consultant and author, Deborah Walker Keegan, PhD, FACMPE, recently addressed a small group of Catalyst Learning customers grappling with healthcare reform’s impact on workforce development.  Dr.  Keegan spoke to the need for new staffing models in this era of industry transformation. There’s one thing most can agree on:  payment reform is at the center of the issue.  Dr. Keegan pointed out that payment reform is driving structural reform, which in turn is driving the delivery system reform. To remain competitive, hospitals are seeking higher levels of integration both horizontally within their own systems and with other hospitals while simultaneously acquiring physician practices.  The resulting environment is one that’s ripe for tighter hospital-physician collaboration. Dr.  Keegan spoke to the need for new staffing models in this era of industry transformation.  She shared an innovative medical practice model that includes a core team of “super-trained associates”.  These employees possess the skills needed to be successful in a variety of roles in a medical practice.  This provides the ability to reassign roles without impacting care. “There is a real change in terms of the clinical support model in the medical practice setting.  The staff is doing synchronous work, and these employees own it instead of simply waiting for work to be delegated…  in a physician practice applying this model, the medical assistant can be responsible for care transition; LPNs can coach patients; RNs can treat complex illness—each with a vital role to play in patient health and wellness,” Keegan explains.  The physician role then becomes one of oversight of the care delivery process as well as providing care where appropriate. This makes willingness to collaborate and flexibility a priority.  In terms of the skill needs, clinical employees and nurses must have the ability to wear many hats.  They must possess strong critical thinking skills and know how to evaluate the whole body/person, not just the symptoms.  Practices must place more emphasis on patient education, prevention, and health coaching support. Many roles are changing, such as case managers, which Keegan explains can be filled virtually, in some circumstances. “If they are onsite, definitely integrate them into the practice,” Keegan says.  “If virtual however, case managers can operate on the periphery.  Of course, telephone and internet nursing takes a different kind of skill, it requires more critical thinking and diagnostic acumen.  These associates should also be very integrated to electronic health records so the physician can evaluate the advice and triage provided to patients, with the case manager playing an integral role in managing chronic care and high risk patients.” An evolving workforce commands the development of new curricula based on new roles.  Healthcare leaders must identify, and overcome, specific skills and curriculum gaps.  The challenges are great, but an industry in profound transition also equals an industry with new opportunities.  Due to these changes hospitals will see a 1.1% projected annual growth rate, between now and 2018. Ambulatory services will see a projected 3.1% annual growth rate in the same time frame. This growth rate will yield thousands of new positions in home health aide, registered nursing and medical case manager positions.




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